Neuroprotective and Antineuroinflammatory Effects of Hydroxyl-Functionalized Stilbenes and 2-Arylbenzo[b]furans.

The drugs currently used to treat Alzheimer's disease (AD) are limited in the benefits they confer, and no medication has been clearly proven to cure or delay the progression of AD. Most candidate AD drugs are meant to reduce the production, aggregation, and toxicity of amyloid ß (Aß) or to promote Aß clearance. Herein, we demonstrate the efficient synthesis of hydroxyl-functionalized stilbene and 2-arylbenzo[b]furan derivatives and report on the neuroprotective and anti-inflammatory effects of these phenolic compounds in vitro and in an animal model. Structure-activity relationships revealed that the presence of an acrylate group on 2-arylbenzo[b]furan confers neuroprotective and anti-inflammatory effects. Furthermore, compounds 11 and 37 in this study showed particular potential for development as disease-modifying anti-Alzheimer's drugs, based on their neuroprotective effects on neuron cells, their antineuroinflammatory effects on glial cells, and the ability to ameliorate nesting behavior in APP/PS1 mice. These results indicate that 2-arylbenzo[b]furans could be candidate compounds for the treatment of AD.

A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study.

INTRODUCTION: This study aimed to investigate different types of regional anesthesia for cesarean section (CS) following epidural labor analgesia that could lead to various perioperative and postoperative outcomes. METHODS: We retrospectively included those parturients who received epidural labor analgesia but needed subsequent CS under regional anesthesia in our institution from January 2008 to June 2012. RESULTS: In all, 2341 of 6609 parturients underwent painless labor, and 334 of them converted to CS. Spinal anesthesia (SA) was used with 163 parturients, and epidural anesthesia (EA) with 96; the two groups were then compared. No high-level block or total SA was noted. The primary outcome revealed that the time from anesthesia to surgical incision and the total anesthesia time were shorter, hypotension episodes were more frequent, the rate of perioperative ephedrine administration was higher, and the rate of midazolam was lower in the SA group. With regard to secondary outcomes, the Apgar scores of the neonates recorded at 1 minute and 5 minutes and maternal satisfaction were similar. The neuraxial morphine dose was converted to parenteral morphine equivalent dose (MED), which revealed that the parturients in the spinal morphine group had lower dosages and visual analog scale (VAS) pain scores on postoperative Day 1. CONCLUSION: For parturients with labor epidural analgesia needing CS, the use of SA led to shorter anesthetic time and lower postoperative pain scores, with lower morphine doses compared with EA. However, the high failure rate with both neuraxial techniques needs to be addressed.

Unexpected intraoperative desaturation and lobar atelectasis due to left bronchial occlusion by concealed ascending aortic aneurysm.

An 81-year-old male scheduled for debridement of a perianal abscess sustained acute upper airway obstruction with atelectasis of the left lower lobe during induction of anesthesia. Results of a fiberoptic bronchoscopy revealed dorsal bulging and obstruction of the left bronchus. Under the context of tortuous aorta and calcified left border of the heart silhouette, aortic aneurysm was suspected; the diagnosis was confirmed by a computed tomography scan. Aortic aneurysm without specific symptoms cannot be screened by a single preoperative chest X-ray. The anesthesiologist should promptly request further radiographic studies to rule out potential aortic pathology if in doubt.